SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
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Under the Securities Exchange Act of 1934
SCHEDULE 13G
INFORMATION STATEMENT PURSUANT TO RULES 13d-1 AND 13d-2
UNDER THE SECURITIES EXCHANGE ACT OF 1934
Nephros, Inc.
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(Name of Issuer)
Common Stock, par value $0.001 per share
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(Title of Class of Securities)
640671103
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(CUSIP Number)
December 31, 2004
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(Date of Event Which Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to which this Schedule
is filed:
|_| Rule 13d-1(b)
|_| Rule 13d-1(c)
|X| Rule 13d-1(d)
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SCHEDULE 13G
CUSIP No. 640671103
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1) NAME OF REPORTING PERSON
S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
Eric A. Rose, M.D.
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2) CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) |_|
(b) |_|
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3) SEC USE ONLY
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4) CITIZENSHIP OR PLACE OF ORGANIZATION
United States
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NUMBER 5) SOLE VOTING POWER
OF 848,080*
SHARES --------------------------------------------------
BENEFICIALLY 6) SHARED VOTING POWER
OWNED BY 0
EACH --------------------------------------------------
REPORTING 7) SOLE DISPOSITIVE POWER
PERSON 848,080*
WITH --------------------------------------------------
8) SHARED DISPOSITIVE POWER
0
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9) AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
848,080*
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10) CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES
|_|
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11) PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
6.9%
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12) TYPE OF REPORTING PERSON
IN
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* Includes 102,929 shares issuable upon exercise of options granted under
the Issuer's 2000 Equity Incentive Plan which vest on or prior to December 31,
2004.
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Schedule 13G
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Item 1(a). Name of Issuer:
Nephros, Inc.
Item 1(b). Address of Issuer's Principal Executive Offices:
3960 Broadway
New York, New York 10032
Item 2(a). Name of Person Filing: Eric A. Rose, M.D.
Item 2(b). Address of Principal Business Office or, if None, Residence:
177 Fort Washington Ave.
7th Floor, Room 435
New York, New York 10032
Item 2(c). Citizenship: United States
Item 2(d). Title of Class of Securities:
Common Stock, par value $.001 per share
Item 2(e). CUSIP Number:
640671103
Item 3. If this statement is filed pursuant to section 240.13d-1(b), or
240.13d-2(b) or (c), check whether the person filing is a:
(a) |_| Broker or Dealer Registered Under Section 15 of the Act
(15 U.S.C. 78o)
(b) |_| Bank as defined in section 3(a)(6) of the Act (15 U.S.C.
78c)
(c) |_| Insurance Company as defined in section 3(a)(19) of the
Act (15 U.S.C. 78c)
(d) |_| Investment Company registered under section 8 of the
Investment Company Act of 1940 (15 U.S.C. 80a-8)
(e) |_| Investment Adviser in accordance with ss.
240.13d-1(b)(1)(ii)(E)
(f) |_| Employee benefit plan or endowment fund in accordance
with ss. 240.13d-1(b)(1)(ii)(F)
(g) |_| Parent Holding Company or control person in accordance
with ss.240.13d-1(b)(ii)(G)
(h) |_| Savings Association as defined in ss.3(b) of the Federal
Deposit Insurance Act (12 U.S.C. 1813)
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(i) |_| Church plan that is excluded from the definition of an
investment company under ss.3(c)(15) of the Investment
Company Act of 1940 (15 U.S.C. 80a-3)
(j) |_| Group, in accordance with ss.240.13d-1(b)(ii)(J)
Item 4. Ownership.
(a) Amount beneficially owned: 848,080
(b) Percent of class: 6.9%
(c) Number of shares as to which such person has:
(i) Sole power to vote or to direct the vote: 848,080
(ii) Shared power to vote or to direct the vote: None
(iii) Sole power to dispose or to direct the disposition of:
848,080
(iv) Shared power to dispose or to direct the disposition of:
None
The shares reported as beneficially owned include 102,929 shares
issuable upon exercise of options granted under the Issuer's 2000
Equity Incentive Plan which vest on or prior to December 31, 2004.
Item 5. Ownership of Five Percent or Less of a Class.
Not applicable
Item 6. Ownership of More than Five Percent on Behalf of Another Person.
Not applicable
Item 7. Identification and Classification of the Subsidiary Which Acquired
the Security Being Reported on by the Parent Holding Company.
Not applicable
Item 8. Identification and Classification of Members of the Group.
Not applicable
Item 9. Notice of Dissolution of Group.
Not applicable
Item 10. Certification.
Not applicable
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SIGNATURE
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After reasonable inquiry and to the best knowledge and belief of the
undersigned, the undersigned certifies that the information set forth in this
Statement is true, complete and correct.
January 31, 2005
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Date
/s/ Eric A. Rose, M.D
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Eric A. Rose, M.D
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